DSA2018: Global inequalities
This panel consists of presentations that draw on scholarly reviews and quantitative analyses to discuss the nature and distribution of inequalities in child health and nutrition, and some of the key drivers of poor health and nutritional outcomes.
Malnutrition and poor health outcomes constitute some of the major challenges that many countries, especially those in developing regions, continue to grapple with. While the socio-economic situation in many developing countries have improved over the years, these improvements have not necessarily been equally distributed across the population. Evidence suggests that inequalities within and between various groups in countries, and across countries are widening. Also, there are striking disparities in health, nutritional outcomes and access to basic services, across geographical locations and between groups of different socio-economic status. This panel presents a collection of papers that provide insight into the levels and distribution of inequalities in child health and nutritional outcomes, based on research conducted in several African and South American countries. A number of these papers rely on nationally representative household surveys to examine the levels, nature and distribution of these inequalities. There is a focus on health and nutrition inequalities that are deemed as detrimental to long term economic and human development, for example stunting. The panel will also consider some of the drivers of these emerging inequalities as well as the policies and strategies that can be used to strengthen access to basic services and improve child nutritional outcomes.
This panel has so far received 5 paper proposal(s).
Terrorist violence and newborn health. Estimates for Colombia
This paper assesses the impact of terrorist violence experienced during pregnancy on children's birthweight using data from Colombian DHS surveys matched with terrorist events records. There is a decline in birthweight for boys, but the impact is mitigated by the mother's education.
Experiences during pregnancy, a sensitive period for child development, can have lasting impacts on health and other outcomes later in life. This paper examines the intergenerational effects of war violence on newborns' health. Exposure to violence by the mother while pregnant can affect the foetus' health through increased levels of 'stress hormone'; the health deterioration would be evident in birthweight as it reflects the cumulative pregnancy conditions. As in previous studies analysing countries with sustained internal conflict, I exploit the geographic and time variation of violence for the identification strategy. To get this variation, I match household survey data from DHS surveys with records of terrorist attacks in Colombia, a country with a long running internal armed conflict. Because the exact timing and location of a terrorist attack is unpredictable, these events can be taken as exogenous sources of variation in violence exposure.
Results suggest that exposure to terrorist violence during the first pregnancy trimester has a large negative impact on birthweight, but that the effect is mitigated by the mother's education. The findings are driven by the effects on baby boys, as there is no effect on girls' birthweight. Additionally, exposure to terrorist violence decreases the prevalence of some negative behaviours during pregnancy (drug use and smoking), but this time, the effect is only apparent when the baby is a girl. While the most likely mechanism for the effect of violence on newborn health is biological (through the mother's hormones), the results suggest that behavioural channels are also operating.
A comparative analysis of socioeconomic inequalities in stunting: a case of three middle-income African countries
Using data from Demographic and Health Surveys (2007-2014) conducted in three middle-income African countries, we examine inequalities in stunting levels. We find that stunting rates have declined, but inequalities in stunting have increased, particularly among the poorest and those in urban areas.
Stunting is the most prominent form of malnutrition and affects close to a third of children in Africa. The causes of stunting include poverty, lack of food and disease. Thus, a reduction in stunting could be achieved through combined and cumulative progress in nutrition, health and improved socio-economic conditions. We use data from Demographic and Health Surveys conducted between 2007 and 2014 in Ghana, Kenya and Zambia to conduct a comparative assessment of stunting. These countries have transitioned from low income to middle-income status, due to increased economic growth, higher commodity prices and rebasing of the national accounts. Using concentration curves and indices, we examine inequalities in stunting rates across wealth quintiles, as well as geographical locations. Our analysis shows that stunting rates have reduced in the countries, but the biggest reductions have occurred in Ghana and Kenya where stunting declined by 9% points over a 6-year period, while Zambia's stunting rate fell by 5% points. However, despite these reductions, stunting rates are still high, particularly in Zambia where over 40% of children are affected. In all three countries, children living in the poorest wealth quintiles are most affected, as well as those in rural areas. Our analysis shows that inequalities in stunting have widened over time in all three countries especially in the poorest wealth quintiles and urban areas. Our results suggest the need for continued focus on improving socio-economic levels of poor households and targeted social protection programmes to reduce inequalities if children nutritional outcomes are to improve.
Evidence of Between- and Within-Household Child Nutrition Inequality in Malawi. Does the Gender of the Household Headship Matter?
This paper uses a linear random effect model to investigate inter-household and intra-household inequalities in under-five children's nutritional status in Malawi by gender of the household head. It provides policy suggestions for nutritional and redistributive policies design.
This paper uses a variance decomposition approach to investigate inter-household and intra-household inequalities in under-five children's nutritional status in Malawi and distinguish between explained and unexplained variance. The adopted linear random effect model is based on a version of the conceptual framework established by UNICEF and the adopted dataset is from the Malawian Endline Survey 2014. The selected impact variable is child stunting. The explanatory variables are representative of the underlining and basic causes of this nutritional status. This study adds to the literature the estimate by gender of the household headship and an up-date evidence on the Malawian case where prevalence of child malnutrition is rampant
The results reveal important distinguishing features of the effect of between- and within-household inequality on child nutritional status. Between-household inequalities, especially those unexplained by the adopted model, mostly drive the long-term child nutritional inequalities.
The results provide policy suggestions for the design of nutritional and redistributive policies aimed at reaching the Sustainable Development Goals and the country's growth and development strategy.
Does inclusive growth reduce nutritional inequality?
This paper investigates nutritional inequality, which uniquely but negatively influences global human development. Investigating the health data in countries with rapid economic growth, this research alerts to the fact that inclusive growth may not simply improve people's nutritional choices.
The concept of inequality has been researched by a number of scholars and development practitioners. After reviewing the existing knowledge on income, health, education and gender disparities, this paper further investigates the complication of nutritional inequality, which uniquely but negatively influences global human development. Investigating the available health data in countries with rapid economic growth, this research alerts to the fact that increasing income per capita (or GNI) may contribute to improving people's food access, but not always making their "nutritional choices" better. This study explores how inclusive growth can reduce nutritional inequality.
This panel has so far received 5 paper proposal(s).